Provider Demographics
NPI:1811774615
Name:LUNA, LISA KAY (REGISTERED NURSE)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:KAY
Last Name:LUNA
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:MISS
Other - First Name:LISA
Other - Middle Name:KAY
Other - Last Name:SANCHEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5914 DEER HORN DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78238-2606
Mailing Address - Country:US
Mailing Address - Phone:210-430-7155
Mailing Address - Fax:
Practice Address - Street 1:5914 DEER HORN DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-2606
Practice Address - Country:US
Practice Address - Phone:210-430-7155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX769804163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty